Introduction In India, there were reportedly 11.8 million teenage pregnancies in 2017. According to the National Family Health Study 4 (NFHS 4), 9.2 percent more women aged 15 to 19 were pregnant or already moms at the time of the survey in rural areas than in urban areas (7.9 percent) (5 percent ). Tripura (18.8%), West Bengal (18%), and Assam (14%) had the highest rates of teenage pregnancies in the nation (NFHS-4).
According to the most recent statistics from the National Family Health Survey-5, the rates in Tripura jumped from 18.8 to 21.9 percent, while they decreased by just 2 percent in West Bengal and Assam.
Globally, the number one cause of mortality for girls between the ages of 15 and 19 is difficulties related to pregnancy and childbirth, with low- and middle-income nations accounting for 99 percent of all maternal fatalities among women between the ages of 15 and 49. Teenage pregnancy is a widespread issue that is more likely to affect marginalised communities due to factors like poverty, a lack of educational options, and job possibilities. It continues to be a significant factor in maternal and infant mortality, as well as intergenerational cycles of illness and poverty.
In 2007, the Indian government passed the Prohibition of Child Marriage Act and launched a number of media efforts to raise public awareness of the negative impacts of adolescent pregnancy and child marriage. The country’s teenage pregnancies decreased by approximately 50% as a result of the initiatives, but only by 2% in areas like Assam.
Globally, the number one cause of mortality for girls between the ages of 15 and 19 is difficulties related to pregnancy and childbirth, with low- and middle-income nations accounting for 99 percent of all maternal fatalities among women between the ages of 15 and 49.
A comparative study was conducted to better understand the factors that contribute to teenage pregnancies in Assam. The results of the study show that there are numerous intersecting causes for teen pregnancies. The main obstacles were found to be a lack of education, access to contraception and health information, and decision-making freedom. In contrast to other religions and castes, the study, which involved over a thousand participants, found that the prevalence of teenage pregnancy was higher in rural Assam, among women with no formal education or less than five years of formal education, women from the Muslim community, and women from the Scheduled Castes.
Teenage pregnancy affects a number of social development indicators, including those related to education, gender, health, and nutrition. These indicators include those that cause or contribute to severe anaemia during pregnancy, low birth weight, and childhood malnutrition, among others. Understanding the drivers of the phenomema in high occurrence locations is crucial if we are to address teenage pregnancy from an intersectional perspective of gender and health.
The Socio-Economic Status of Teenage Mothers Although a teenage pregnancy affects the entire socioeconomic structure of society, moms are the ones who suffer the most. According to a study conducted in Assam’s most needy regions, more teenage moms were married as a result of the family’s low financial situation or after eloping than women who became pregnant after the age of 20. Compared to women from scheduled tribes (ST) or the general category, a larger percentage of women from scheduled castes (SC) and other backward classes (OBC) had teenage pregnancies.
Furthermore, while a larger percentage of women in the comparison group continued to live in nuclear households, nearly 47% of the teenage moms lived in joint families. While many teenage girls attended school, more women in comparable categories (non-teenage mothers) completed their education by the 11th grade or higher.
Regarding the family members’ ages, particularly those of the women, the study produced a startling observation. While there was no discernible difference in the mother-in-age law’s at marriage between the two groups, there was a difference in the participant’s own mother’s age at marriage. Most of the mothers of adolescent mothers were under the age of sixteen when they were married.
Access And Usage Of Contraception and Other Health Services Compared to the comparison group, a considerably smaller percentage of teenage moms believed that contraceptives were easily accessible to them. The use of contraceptives varies significantly between adolescent moms and those who fell pregnant after the age of 19. In comparison to teenage pregnant mothers, the comparison group of non-teenage mothers reported a much greater rate of contraception use.
Social and emotional learning must be combined with the education on sexual health. Unwanted or teenage pregnancies only have negative effects on a woman’s sexual or reproductive health, but they also have a significant social and emotional toll on the mother.
Additionally, the comparison group’s women believed there was a risk in 77 percent of cases compared to the adolescent mothers’ 50 percent, and this difference was determined to be statistically significant. Compared to 66 percent of adolescent mothers, 80 percent of women in the comparison group received four or more ANCs. The majority of participants from both categories (almost 77%) preferred to give birth at the government facilities, which lowers the probability of an unattended skilled birth.
Despite greater awareness about contraceptives and their accessibility, social pressure to use them has persisted. The majority of the women cited tablets as the most practical method of birth control and revealed that they don’t tell their husbands or other family members they’re using the pills. The health frontline workers were the respondents’ primary source of health information, although a larger percentage of adolescent moms relied on sources besides the three frontline workers, such as family, friends, panchayat officials, and religious influences. Particularly, when compared to the comparison group, pregnant teenagers were much more likely to seek out information from religious institutions.
More over half of the participants also had access to mobile phones. While radio use is comparable across the two groups, a disproportionately higher proportion of women in the comparison group have access to televisions and computers or laptops than do adolescent mothers. Additionally, it was discovered that teenage mothers used social media less frequently than the comparison group.
Revamping the Sexual Health Programme in India India began its national adolescent health programme, Rashtriya Kishor Swasthya Karyakram (RKSK), and the Adolescent Reproductive and Sexual Health Strategy (ARSH) (2005-2013) in response to the urgent need to address the health hazards, particularly sexual and reproductive risks, of its young population (2014-present). Even while RKSK is an improvement over ARSH, India still has a ways to go. Convergence has come to be recognised as a major problem at the policy level. According to a recent fast evaluation, insufficient monitoring and lack of ownership over programme components by non-health departments continue to pose problems for implementation of interdepartmental links.
It is essential to broaden both the range of services offered and the pathway via which they are provided. The initiatives need to include more private providers, counsellors, and educators while still placing a strong emphasis on FLWs and peer educators. Social and emotional learning must be combined with the education on sexual health. Unwanted or teenage pregnancies only have negative effects on a woman’s sexual or reproductive health, but they also have a significant social and emotional toll on the mother. Trained counsellors can be a crucial resource for offering psychosocial support in addition to peer educators.
The sexual health programme in India needs to be delivered with interdepartmental convergence, incorporating educators and counsellors along with a component of psychosocial support, keeping in mind the intersectionality. The secret to preventing adolescent pregnancy and marriage can be twofold: first, educate the girls and make sure they complete their desired education by keeping them in school, and second, include men and other community members in the discussion.
Extending the pregnancy conversation to men in influential positions Women’s reproductive health is a topic that is frequently socially secluded. While the obligation of healthcare is through the partnership of a man and a woman, childcare is frequently limited to the woman. The topic of pregnancy needs to be discussed with husbands, dads, brothers, fathers-in-law, faith leaders, PRI members, and other community influences.
While the range of contraceptives for women is expanding, this places more responsibility on women without taking into account the fact that they have less autonomy and birth control decision-making space than men. It is time that males receive equal attention in our family planning programmes. Policymakers recognised this problem decades ago, but there is still a gap in implementation.
Poor financial standing, lack of education, early marriage, a lack of desire to use contraception, a lack of involvement in child care, and a host of other factors can all contribute to teen pregnancy. Beyond the frontline health providers, community influencers—often men—play a key role in influencing teenage moms.
The secret to preventing adolescent pregnancy and marriage can be twofold: first, educate the girls and make sure they complete their desired education by keeping them in school, and second, include males and other community members in the discussion.
The inclusion of thorough sensitization programmes for men could have a significant impact on the vicious cycle of delaying conception, spacing births, and ensuring the health and nutrition of mothers. Additionally, while working with male community members, female health workers frequently encounter personal, social, and cultural hurdles that exclude them from the dialogue. Family planning and other sexual and reproductive health programmes in India could benefit greatly from an increase in the number of men working at the front lines.
